Provider Demographics
NPI:1194047878
Name:PATTERSON, CHRISTINE D (PHARM D)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:D
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:D
Other - Last Name:DEMARIA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARM D
Mailing Address - Street 1:19942 HICKORY STICK LN
Mailing Address - Street 2:
Mailing Address - City:MOKENA
Mailing Address - State:IL
Mailing Address - Zip Code:60448-1368
Mailing Address - Country:US
Mailing Address - Phone:708-307-1367
Mailing Address - Fax:
Practice Address - Street 1:1500 W LINCOLN HWY
Practice Address - Street 2:
Practice Address - City:NEW LENOX
Practice Address - State:IL
Practice Address - Zip Code:60451-1529
Practice Address - Country:US
Practice Address - Phone:815-485-2166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-22
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051287588183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist